MEDICARE: HAIDER ALRAMLI

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	100190	CA
2	1223P0300X	Periodontics	24533	FL
3	1223P0300X	Periodontics	123227	GA

General Provider Information

NPI Number	:	1063869709
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HAIDER ALRAMLI

Provider Business Mailing Address
First Line	:	3700 US HIGHWAY 98 N UNIT 105
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33809-3863
Country	:	US
Telephone Number	:	619-729-9579
Fax Number	:

Provider Business Practice Location Address
First Line	:	3700 US HIGHWAY 98 N UNIT 105
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33809-3863
Country	:	US
Telephone Number	:	619-729-9579
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2016
Last Update Date	:	08/21/2023

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Directions to “ HAIDER ALRAMLI ” Practice Location

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